A Morning in San Francisco

Alright, mostly just photos. Mostly about food.

We began the morning with breakfast at Sears Fine Food. Years ago (before the timeshare), we used to stay at the Chancellor, right next door. Then we stayed at a hotel on the other side of the Saint Francis at Union Square, and now we're on the opposite corner and about 3 minute's walk at a timeshare. If you stay in SF, stay close to Union Square. Just trust me. You'll have an amazing time. We do several weekends per year.

On the way, we went up to the 36th floor of the Grand Hyatt to take this.

San fran am

[Read more...]

Weekend

I'm likely to get something off in the AM, links most likely.

For the time being, I'm sitting at the bar in the Daily Grill, just off Union Square in amazing San Francisco.

As much as they try, the commies just can't seem to completely ruin it. I'm eternally charmed and count myself lucky to live a mere hour's drive away.

Next up: Morton's Steakhouse.

Weekend

What Do You Think You Know About LDL Cholesterol? (Pt 2 of 2)

Part One

The purpose of part one was to demonstrate the meaninglessness of calculated LDL cholesterol in relation to the equation used to calculated it, and how triglycerides, while being a very important risk factor for heart disease in its own right, have been steadily increasing on average and potentially giving a false sense of security as increases in triglycerides cause a mathematical (not necessarily biochemical) lowering of calculated LDL serum cholesterol.

I promised that in this second and final part, I will demolish the notion that you have any real idea of what your actual LDL cholesterol is, based on standard bloodwork involving calculated values. And I shall deliver.

Let me frame what I'm going to say this way: there are millions of people with low calculated LDL (say, <50-60) who are at infinitely more risk for atherosclerosis, rupture, and fatal heart attack than are many people with calculated LDLs in the high 200s and higher. If you eat significant amounts of carbohydrate, especially as processed food, have low HDL (<60), high triglycerides (>200), then it's essential to know exactly what your LDL really is. The standard blood panel is essentially worthless for this.

But I'm here to help. But first, let me show you what I mean by turning to Dr. William Davis, the cardiologist who originated Track Your Plaque and who blogs at The Heart Scan Blog. Dr. Davis, who used to practice by performing various coronary procedures such as installing stents, now spends his time detecting, preventing, and reversing heart disease.

He has lots of stories to tell. Let's get started.

Don't believe your LDL cholesterol!
"Harry's case is typical. For years, his doctor told him his LDL cholesterol of 123 mg was okay. But a heart scan score of 490 (90th percentile at age 52) made him question just where his coronary plaque came from.

"Lipoprotein analysis told a very different story: His LDL particle number was 2400 nmol, meaning his true LDL was more like 240 mg, nearly double the value of LDL obtained through his doctor. Harry had other sources of risk, too, but the LDL particle number was a clear stand-out. [...]

"...When LDL's are actually meaured, you find that LDL is rarely accurate. In fact, in our experience, inaccuracy of 30-50% is the rule, sometimes 100%. The one telltale hint that calculated LDL is wrong is when HDL is <50 mg -- that's nearly everybody. "

How accurate is LDL cholesterol?
"If there's so much attention paid to LDL, how accurate is it? 100%? 90%? 80%?

"Well, it varies widely. Occasionally, it's truly accurate, but most of the time it's miserably inaccurate. Every single day, I see people with LDL cholesterols that underestimates true (measured) LDL by 40%, 50%, and even over 100%. In other words, LDL cholesterol might be 120 mg/dl by the conventional method, but the genuine measured value might be 160 mg/dl, or even 240 mg/dl. It can be that far off -- and it's not rare.

"The converse can occasionally be true, though rarely in my experience: that conventional LDL overestimates true LDL. I saw someone in the office today like this, with a conventional LDL of 142 mg/dl but a true measured LDL of 115 mg/dl. I may see one or two more people like this the rest of this year."

When LDL is more than meets the eye
"I pointed out to Jerry that, given the low HDL and high triglycerides, his calculated LDL of 112 was likely inaccurate. In fact, if measured, LDL was probably more like 140-180 mg/dl. LDL particles were also virtually guaranteed to be small, since low HDL and small LDL usually go hand-in-hand (though small LDL can still occur with a good HDL).

"So Jerry's LDL is really much higher than it appears. To prove it, Jerry will require an additional test, preferably one in which LDL is measured, such as LDL particle number (NMR), apoprotein B, or "direct" LDL.

"It's really quite simple. Jerry likely has a high number of LDL particles that are too small. This pattern confers a three- to six-fold increased risk for heart disease."

The many faces of LDL
"Ginnie came in for an opinion about her heart scan score of 393. At age 57, this put her in the 99th percentile, a high score.

"LDL cholesterol: 96 mg/dl - This value puts Ginnie's LDL in the most favorable 25% in the country.

"LDL particle number: 2140 nmol/l - This value is in the worst 25% of the country and is the equivalent of an LDL cholesterol of 214 mg/dl (take off the zero).

"In addition, over 90% of Ginnie's LDL particles fell into the small class."

Making Dr. Friedewald an honest man
"Colleen started with the usual discrepancy between conventional calculated LDL cholesterol of 121 mg/dl and the far more accurate LDL particle number (NMR) of 1927 nmol/L. [...]

"In other words, by this simple manipulation, Colleen's Friedewald calculated LDL is off by 58%. This is very common, a phenomenon I witness several times every day.

"By LDL particle size, 75% of all Colleen's LDL particle were abnormally small (small LDL particle number 1440 nmol/L). This is a moderately severe small LDL tendency."

A Tale of Two LDL's
"Kurt, a 50-year old businessman with a heart scan score of 323, had a:

"--Conventional (calculated) LDL of 128 mg/dl - Real measured LDL 241 mg/dl.

"Laurie, a 53-year old woman who underwent a coronary bypass operation last year (before I met her), had a:

"--Conventional LDL of 142 mg/dl - Real measured LDL was 85 mg/dl.

"(By "real, measured" LDL, I'm referring to LDL particle number in units of nmol/L obtained through NMR lipoprotein testing and dividing by 10, or just dropping the last digit to convert the value to mg/dl. This technique was arrived at by comparing the population distributions of these two parameters, LDL particle number and calculated LDL. This is the gold standard in my view. Similar numbers can be obtained by measuring apoprotein B, direct LDL, or calculated non-HDL, with diminishing reliability from first to last.)

"In other words, Kurt's conventional LDL underestimated real LDL by 88%. Laurie's conventional LDL overestimated real LDL by 40%."

~~~

Had enough? Now do you see what I mean? I'll finish by quoting the heroic Dr. Davis once more from the last of those series of links.

Interestingly, Laurie's doctor had insisted she take Lipitor for a high LDL cholesterol. Her real LDL was, in fact, low to begin with and benefits of a statin drug would be little to none. (Remember, in our Track Your Plaque approach, multiple other treatments are included, such as omega-3 fatty acids from fish oil, vitamin D normalization, and wheat elimination, strategies that yield benefits that others expect to obtain with statins.) Laurie's real cause of her heart disease proved to have nothing to do with LDL cholesterol, but involved lipoprotein(a) and thyroid issues.

Kurt proved to have a severe preponderance of small LDL particles--the worst kind of LDL, while Laurie had none--a benign pattern.

Then how can anyone make sense of the conventional, calculated LDL cholesterol that is generally (95% of the time) provided? If accuracy can stretch to plus or minus 80% . . . you can't. Conventional LDL is a miserably inaccurate number. The problem is that obtaining a superior number requires a step or two more testing and insight, something most busy primary care doc's simply don't have in the midst of a day filled with arthritis, bronchitis, diarrhea, belly aches, and seborrhea.

Yet conventional--I call it "fictitious"--LDL serves as the basis for this $27 billion (annual revenues) industry selling statin drugs.

This is meant to be neither an argument in favor of nor against statin drugs. However, it is plain as day that any study designed to reduce LDL cholesterol will be hopelessly clouded by calculated LDL imprecision. A calculated LDL of, say, 143 mg/dl might really be 187 mg/dl, or it might be 74 mg/dl--you can't tell by looking just at LDL. Yet billions of dollars of research and billions of dollars of healthcare costs are based on the treatment of this number.

So, what's your LDL? Unless you've actually had it measured, you do not know. Neither does your doctor. Are you on medications or dietary prescriptions as a result of the fiction that you believe is your LDL? And how about particle size? Large & fluffy are actually good, while small and dense are very bad. You might have a low LDL, but with a high percentage of small and dense particles, and you could be at 6 or 10 times the risk as someone with an LDL of 250, but 99% large & fluffy. Don't be fooled by your doctor, HMO, hospital, or the drug companies.

And guess what will reduce your small and dense LDL every time? You guessed it: get off the grains, (particularly wheat), sugar, processed foods, processed vegetable oils; and take omega 3s and vitamin d to get your levels above 60.

How do you find out what your LDL actually is? Dr Davis says, "Our preferred method is NMR (LipoScience) LDL particle number, probably the most accurate of all. Second best: apoprotein B, direct measured LDL, and non-HDL."

Thanks

Thanks to all of you for the many wishes for a happy birthday by email and writings on the wall on Facebook. I really appreciate it, and hope this single post serves as adequate acknowledgement. I turned 48 today.

Still working a few bits on the second LDL cholesterol post, but I'll be up later.

Just Go Ahead And Wait For “Public Policy”

I had to laugh.

The National Institutes of Health awarded Creighton University $4 million to continue its landmark study linking vitamin D to a reduction in cancer risk. The study’s findings, reported in June 2007, showed for the first time in a clinical trial that postmenopausal women consuming optimal amounts of calcium supplements, as well as vitamin D3 supplements at nearly three times U.S. government recommended levels, could reduce their risk of cancer by 60 to 77 percent.

“The vitamin D3 finding was a secondary goal in the original study,” said Creighton researcher Joan Lappe, Ph.D. “We must now confirm these findings with a clinical trial specifically designed to look at calcium, vitamin D and cancer. Confirmation is necessary in order to have evidence solid enough to change public policy regarding intake levels for vitamin D.” [...]

A total of 2,300 women will be recruited and followed for four years with half of the participants randomly assigned to take daily supplements containing 2,000 IU of vitamin D3 and 1,200 mg of calcium; the second group will receive placebos. (emphasis added)

There you go. Something that's intuitively pretty obvious (that most plants and animals need sunlight for various metabolic and biochemical processes) needs to wait four years so that greater exposure to natural, life giving sun (and/or vitamin D supplementation at sufficient levels) can receive the blessings of the "authorities" -- you know, like the people that have been advocating low fat, high carbohydrate diets for the last two decades as obesity and diabetes skyrocket; those kinda guys.

Moreover, I'm not hopeful by any means that even when they do get around to revising recommended daily intake upwards that it will be anywhere near what would be needed to get someone's 25(OH)D levels into the 60-80 ng/ml range. Why 60-80? See here.

Then this, from a recent email newsletter from Dr. John Cannell of the Vitamin D Council.

The Institute of Medicine (IOM) has quietly announced composition of the next vitamin D Food and Nutrition Board (FNB), a committee that will set recommendations for both adequate intake and upper limits well into the next decade. [...]

Unfortunately, the scientists who have led the vitamin D revolution for the last ten years are all excluded. The debarred include, but are not limited to, Drs. Vieth, Giovannucci, Garland, Hollis, Heaney, Wagner, Norman, Hankinson, Whitting, Hanley, etc.. For example, Dr Hollis actually wrote and received an FDA Investigational New Drug (IND) for vitamin D in 2003 that has allowed both him and many other investigators to perform vitamin D studies with doses well above the current upper limits. Why is he not on the committee? Dr. Vieth has performed many of the recent upper limit pharmacological dosing studies in humans. Why did the IOM exclude Dr. Vieth?

Then, of course, there's the utter embarrassment they call the American Academy of Dermatology and their recent ridiculous Position Statement on Vitamin D, which, to my gimlet eye, looks to be more of a position on full and continued employment for researchers and dermatologists.

The American Academy of Dermatology recommends that an adequate amount of vitamin D should be obtained from a healthy diet that includes foods naturally rich in vitamin D, foods/beverages fortified with vitamin D, and/or vitamin D supplements; it should not be obtained from unprotected exposure to ultraviolet (UV) radiation.

What astounding modern arrogance driven by ignorance.

How about this: in lieu of publicly pelting the BoD of the Academy with rotten tomatoes, how about they explain why melanomas are rare in poor, equatorial countries where people don't use sunscreen and work out in the sun a lot, verses higher rates the farther north you go in the northern hemisphere, or south you go in the southern hemisphere, where there's inadequate sunlight, countries are richer, people work indoors, and everyone can afford to be duped into buying and slathering sunscreen?

In the meantime, I'll keep taking my daily dose of 6,000 units of vitamin D, 15 times the levels recommended by "the authorities."

What Do You Think You Know About LDL Cholesterol? (Part One)

Are you aware that the LDL cholesterol results you get in your routine blood workup is likely a complete fiction? That's right, and it's because LDL isn't measured, but calculated. Here's the formula, called the Friedewald equation:

LDL = Total Cholesterol - HDL - Triglycerides/5

So, for example, if one goes on a grain based, high carb, low fat diet which is well known to make triglycerides skyrocket, what would be the effect on your (calculated) LDL, all else remaining about equal? Your LDL would go down, your doctor would be pleased, you'd be ecstatic, and you may have actually increased your risk of, um, death (but maybe not of a heart attack, so yippee!). In fact, both very high and very low LDL associate with all-cause mortality (death from all cause, not just cherry picking heart disease). Where does risk appear to be lowest? I'm not sure, but for cancer risk, it's an LDL of around 130, i.e., lower or higher equals greater risk, and remember, I'm talking about LDL alone.

So, you want to reduce your LDL like a good soldier? Then increase your triglycerides dramatically. All else remaining equal, each 5-point increase in Trigs gets you a point off your LDL. Increase Trigs by 100 (easy to do with grains, sugar, and other refined carbs) and you can lower your LDL by 20.

So what are triglycerides? Most simply, fat circulating in your blood. Government recommendations are for a level of 150 and below. Mine are 47, and what you might not know about high-fat (and consequently low-carb) dieters is that they all have pretty low triglycerides (in the 50-80 area). Those who eat lots of grains and sugars in the form of bread, pasta, rice, processed foods, sweetened sodas, and, yes, fruit juices: you'll see triglyceride (fat circulating in blood) levels of 200 and on up, sometimes way up. 300-400 and above are not uncommon. Alright, so, eat lots of natural fat (from animals, coconut, and olives) in order to reduce your sugar intake (carbohydrate) and you'll dramatically reduce your triglycerides; eat low fat with lots of sugar (carbohydrate -- yes; bread and pasta is, essentially: sugar), raise the fat levels in your blood, and potentially lower your LDL.

Conclusion: a six-pack of Coca Cola per day ought to do the trick. Trigs will skyrocket and your LDLs will probably go down. Your doctor will tell you you're doing a great job, and you can live in ignorant bliss.

Or, you can get wise about triglycerides. Jonny Bowden was out with an informative post a few days ago, Triglycerides: What You Need to Know. Now, with the foregoing Friedewald equation in mind, and my rather pedestrian analysis and examples, get a load of this.

New Analysis Shows Troubling Trend in Triglyceride Levels May Be Linked to Rising Rates of Obesity (that does not look to be a permalink, so you may end up having to search the NLA site)

A new 30-year analysis of the National Health and Nutrition Examination Survey (NHANES) database conducted by the National Lipid Association (NLA) indicates that while Americans are doing a better job of managing LDL or "bad" cholesterol, the percentage of adults with high triglycerides, a blood fat linked to heart disease, has doubled, leaving many people at risk for potentially life-threatening events such as heart attack or stroke. Results of the analysis were presented today at the American Heart Association's Annual Scientific Sessions in New Orleans.

So, now, watch how they can't see the forest through the trees.

Between 1976 and 2006 the number of Americans with unhealthy isolated LDL levels dropped from 43 percent to 40 percent, an improvement that researchers attribute to more aggressive educational initiatives and treatment. However, far less emphasis has been placed on controlling triglycerides. The rising rates of isolated high triglycerides seen over the last three decades underscore the need for physicians and patients to understand and treat all three key lipids, which include LDL, HDL or "good" cholesterol and triglycerides.

Get it? They attribute lower LDLs with better education and treatment, when the Occam's Razor explanation is that by virtue of the equation they use, the majority of the lowering of LDL is likely a simple mathematical relationship having to do with elevated triglycerides. In other words, their "educational initiatives" have been to prescribe low fat, high sugar (carbohydrate) diets, resulting in grossly elevated triglycerides and moderately lower LDLs.

This is the outright FRAUD that's being perpetrated against you by "authorities" and "experts," many in the pay of the drug companies who want you popping statins.

And just in case you don't know, there's really no meaningful association between LDL and heart disease. Time and time again, if hundreds of thousands of heart attack patients are analyzed, half have low LDL and half have high LDL. It's irrelevant. However, the association with high triglycerides is very well established. See here and here and here, and that's just a 5-second Googling. I could get you a dozen more in five minutes.

Even the National Lipid Association, from which this study and statement originate, acknowledges an independent association with triglycerides.

...triglycerides are the third component of the lipid profile and are an independent and compounding risk factor for heart disease, the leading cause of death in the U.S. Studies have shown that the risk of developing heart disease doubles when triglyceride levels are above 200 mg/dL. When triglycerides are above 200 mg/dL and HDL cholesterol is below 40 mg/dL, a person is at four times the risk of developing heart disease.

Tomorrow, in Part Two, I shall demolish the notion that you have any clue as to what your LDL really is. If you are getting standard blood tests, you have no idea what your LDL is, and I can prove it. That number on your printout is completely worthless and meaningless. And, if you take any real stock in it, and you have triglycerides over 150, or even 100, you are probably living under a false sense of security, courtesy of the "experts."

What Do You Think You Know About LDL Cholesterol? (Pt 2 of 2)

Modern Day Weston Price?

Well, perhaps not exactly, but let's see if we can't find something to cheer about. But first, in review:

In 1939, he published Nutrition and Physical Degeneration, a book that details a series of ethnographic nutritional studies performed by Price across diverse cultures.

Some of the cultures studied include the inhabitants of the Lötschental in Switzerland, the inhabitants of the Isles of Lewis and Harris in the Outer Hebrides of Scotland, the Eskimos of Alaska and Canada, the Native Americans, among the inhabitants of New Caledonia, Fiji, Samoa, the Marquesas Islands, Tahiti, Rarotonga, Nukuʻalofa, Hawaii, the Masai, Kikuyu, Wakamba and Jalou tribes of Kenya, the Muhima of Uganda, the Baitu and Watusi of Rwanda, the Pygmies, and Wanande in the Congo, the Terrakeka, Dinka and Neurs of Sudan, the Aborigines of Australia, the inhabitants of the Torres Strait, the Māori of New Zealand, the Tauhuanocans, Quechua, "Andes Indians", "Sierra Indians" and "Jungle Indians" of Peru.

In his studies he found that plagues of modern civilization (headaches, general muscle fatigue, dental caries (cavities), impacted molars, tooth crowding, allergies, heart disease, asthma, and degenerative diseases such as tuberculosis and cancer) were not present in those cultures sustained by indigenous diets. However, within a single generation these same cultures experienced all the above listed ailments with the inclusion of Western foods in their diet: refined sugars, refined flours, canned goods, etc.

The book is available online.

Now comes San Francisco physician, Daphne Miller, and a book called The Jungle Effect. Given the title of this blog, that's certainly a book title that I could get behind.

Jungle_effect

So, just from the cover, I can kinda get an idea of which way this book slants. I'm sure Michael "eat mostly plants" Pollan would approve.

At any rate, thanks to a friend down the hall (thanks, Marcus) I did listen to a radio interview and I think she does get a lot of fundamentals right. Obviously, number one and the thing I can even agree with whole food vegetarians and vegans about: dump the flour, sugar, vegetable oils and all the myriad products derived therefrom, and you'll be way better off. And, in fact, in spite of all the cheering around here over natural fats and the meats they go so well together with, it must be emphasized that the very most critical aspect of all of this is getting the processed frankenfood crap out of your life.

You'll be glad you did, and you may even end up embracing a Paleo-like, high-fat diet, as I do.

Now, this is not a book review. Dave Dixon at Spark of Reason has done a more than adequate job of that.

However, I did listen to the complete 55-minute interview on KQED, public radio. That was quite interesting in that she clearly understands that it's not just natives eating native food, but what happens to some of the natives who venture to the modern world. They get the same sets of diseases, and when they return, they no longer look anything like their brothers and sisters -- no bout a result of many added pounds, as well as the fat-face inflammation that I used to suffer from and so many Americans still do (for more information, consult the "Dean Ornish chubby-face diet"). She also seems to know about disease association issues with vitamin D, and says that virtually 100% of the patients she sees in San Francisco are deficient.

But the real funny thing, one that gives me a different perspective than I had after reading Dave's book review, is her manner of almost apologizing over the issue of fat. In one segment of the interview, she acknowledges healthful cultures that get a lot of fat from heavy cream. She offers it up both apologetically and also as a kind of paradox. In another segment, she admits that the Okinawans totally converted her to being a pork lover and now she even cooks with "modest" amounts of lard. (You know, the Okinawans who live so long because of the white rice and fish they eat.) Anyway, note to the doc: you know about the Inuit "paradox," I gather. How about the Massai, who get about 35% of calories from saturated fat? And most of all, how about the Tokelauans, who get a whopping 50% of their calories, not just from total fat (60%+), but from saturated fat. I trust, good doctor, that you don't need a lesson in hypothesis (diet-heat-cholesterol) falsification.

Anyway, lest I dwell too much on the negative, I am generally positive about Dr. Miller's work, Dan Buettner's Blue Zones work, and heck, even Michael "eat mostly plants" Pollan.

Let's get over processed and "convenient," packaged, flour and sugar laden anti-food, and then we can quibble about how much fat, how much meat, how little vegetable, etc. And, even though I avoid all grains and legumes (as well as dairy), as I want optimal nutrition (and grains and legumes can't hold a candle to meat, fat, veggies, fruits and nuts, when these replace grains and legumes in the diet), there is certainly benefit to handling some of the nastier lectins in grains and legumes through soaking, sprouting, and/or fermenting -- all methods used by various wise cultures over centuries.

Diet Fad Insanity

Here's a couple of articles that came to me by way of email (thanks Karen & Jim).

100-calorie nibbles

For the dieter who's looking to lose a few, the market wants to help you.

For the past couple of years, certain companies have offered small portions of snack foods bundled in 100-calorie packs. Roughly 175 products -- among them Nabisco's Oreos and Teddy Grahams, Hershey's Dark Chocolate and, yes, even Hostess' Twinkies, in the form of Twinkie Bites -- come in small sizes. Do they work?

Weight loss surgery's complications devastate some patients

Sandi Krueger of Turlock dropped 120 pounds with weight-loss surgery, but she is hardly a success story.

The 2002 surgery led to chronic malnutrition and anemia. As the pounds melted away, so did her life.

With a sunken face and protruding collar bones, she is too weak to work and spends most afternoons on the couch wrapped in a blanket.

She has thoughts of giving up, but wants to be there for 12-year-old daughter Megan and 19-year-old son Dustin.

"It's not acceptable leaving me like this," said the 103-pound Krueger, who at 38 looks closer to 50. "I've gone to doctor after doctor and basically they don't help me."

This is a very tragic story and I consider Ms. Krueger and victim of people who should have taken care of her.

Wouldn't it just be so much easier to eat all the meat, natural fat (animal, coconut, olive), vegetables (swimming in fat is A-OK too), fruit (smoothies blended with eggs and lots of fat -- heavy cream and/or coconut milk -- is also A-OK -- (are you detecting a theme, here?)) that you want, get the highest nutrition possible, and watch the pounds melt away, widespread inflammation reduce, and moderate of correct most health problems, particularly those of an autoimmune nature?

Do you know why America is fatter than ever? It is squarely and precisely because its fear of fat is greater than ever. Fat (natural fat) is king. Once you learn this, everything falls right into place.

Ask Mark Sisson

Many of you will recall my guest post over at Mark's Daily Apple. At the time, Mark and I agreed he'd do one here as well, and I decided it would be best to wait until after the holimonth. Well, it's time; and though he and I bounced a few ideas back and forth, I was always left disappointed about all he could've addressed, but wouldn't, in sticking to one subject.

Well, I'm happy to announce that Mark solved that little dilemma by suggesting a guest post that will actually be a lot more work for him.

So here's the deal: Ask Away. Preferably in the comments, but you can also send me an email (the address is on my About page). Of course, anything having to do with food, diet, fitness, weight loss, fasting supplementation, cooking, etc. etc. is fair game.

Want to know more about Mark so that you can be best informed about what to ask? Then read all about him and take in those photos. Also, Mark is the designer of The Primal Blueprint, so you might have a question or two about that. You won't even have to wait for his forthcoming book.

OK, folks, let's make the most of this great opportunity. Once we have sufficient questions I'll get them off to Mark and he'll prepare a guest post to answer as many as he can.

Later: More Ideas For Questions.

Update: You Asked; Mark Sisson Answers

Hot Chicken Bacon Salad

Here's one that I often eat down at Trials Pub, as it's the most Paleo friendly dish on their menu. I didn't take as long to prep this as would normally be called for (more reduction on the balsamic vinegar), but it was very tasty nonetheless.

How it went was there was a chicken breast and a half, three strips of thick-sliced bacon, red onion, spinach, and a bottle of inexpensive balsamic.

Get about 1/3 to 1/2 cup of the vinegar boiling, then simmering to reduce. Ideally, you can get it down to a pretty syrupy consistency but I didn't take the time, this time. Instead, I used the bacon dripping to help it along. So, instead of an olive oil and vinegar preparation, think bacon drippings and vinegar.

So, cut up the chicken into chucks and cut up the bacon into about 1" lengths. Then fry up both together until the bacon is pretty crispy and the chicken is done. Then, chicken goes into the simmering balsamic for the time it takes to prep the spinach. Get a big salad bowl and strain the hot balsamic through a wire mesh over the spinach and toss thoroughly. Then, do exactly the same with the hot bacon dripping and toss immediately.

You can either fry the red a bit prior (to get translucent, or put them in with the spinach and let the heat from the balsamic and fat do its job. This time, I did the latter. You could also boil the onion in the balsamic.

Next, in goes the onion, chicken and bacon to be tossed together, then you serve on plates, leaving the excess dressing in the salad bowl.

Hot chicken bacon salad

Saturday Link Roundup

So much stuff and so little time to comment extensively on everything I'd like to. So, rather than let stuff stack up for the "someday" when I can get to it, I think I'll clean out the queue once per week and just give you the links, along with a quick comment. If I've got a lot, I'll probably split them between Saturday and Sunday entries.

- A friend emails to alert me to PumpOne Workout Software for your iPod or iPhone. Haven't tried it, yet, but looks pretty cool. Also, this friend contacted me a couple of months ago with interest in the Paleo approach and is now happy to report a weight loss of 8-10 pounds; this, after years of trying without success.

- Diana Hsieh shows how to go about cleaning out your pantry to get Paleo compliant.

- In an essential weekend special, Mark Sisson reports on new research that suggests low-carbohydrate diets and go a long way towards rectifying fatty liver. Though the focus is on non-alcoholic fatty liver disease (NAFLD), I suspect that a Paleo diet would be ideal for a recovering alcoholic with a fatty liver, not only because the diet will stimulate the metabolization of those liver fats (that can eventually lead to cirrhosis), but also because of the high nutrition.

- I mentioned using kettlebells in yesterday's post. Here's Chris at Zen to Fitness offering up a good intro featuring Craig Ballantine.

- Here's another from Mark Sisson that's been sitting in wait forever. Grain Pain. Many people wonder what in the world could be the problem with grains. Want to find out? Go off them completely for a few months and then dig back in. If like me and a lot of others, you will then understand completely. Here's a way to think of it: Ever been in a paint shop and gotten knocked over by the noxious fumes? Well, even though nowadays various filtration methods are used, it didn't used to be that way and you'd soon adapt to them. In order to really feel the toxins again, it would be necessary to stay clear for a period of time, such that your sensitivity returns to normal. If you still have frequent "intestinal issues" after being on Paleo-like for months, check the amount of grain and dairy products you're still allowing in your diet. By being "mostly Paleo," chances are you're regaining sensitivities long dormant (kinds like insulin resistance) and grains and dairy now effect you as they should have been doing all along.

- I've posted before about the role of sugar and growth of cancer cells, intuitively leading to speculation that a sugar free, low-carb, ketogenic diet may be effective at stopping or dramatically slowing tumor growth. Now here's Chris Highcock with even more news on the subject.

- Like Keith Norris, I too got wind of this NYT article via Art. The Evolutionary Search for Our Perfect Past. A good read. As well, Keith's post is worth the read owing primarily to his too-gentle takedown of a nitwit blog post I'm not even going to link because they don't deserve it. The Ignorant posing as sophisticate. While Keith's treatment is certainly sufficient, I'd add just a couple of things. First, we all know about Rapid Evolution. Second, it's wholly non sequitur from the standpoint of any individual. Unsurprisingly from the tag-lined descriptions of the nitwit blog, everything is treated from a collectivist standpoint.

Quick Workout Note

Beginning last week, my trainer and I have decided to switch things up. Instead of predominantly lifting weights twice per week, I'm now doing weights once and the other workout is a crossfit styled routing, always different.

So far, I've had two workouts, and we're talking about lots of pull-ups, push-ups, kettlebell swings, and just now, TRX suspension straps, and various other variations of various varieties. Quite a different routine.

I like it. And I shall report. Right here.

This may end up delaying my photo update a few weeks, perhaps to middle or late February (I had intended it for my birthday next week, as I turn 48). Presently, I'm down about 5 pounds net from my last shoot, and so far as I can tell, there's not a lot of visual difference. I'm thinking this just might do the trick, as I become more adapted to the routine. We'll see.

Bea & I are headed up to the cabin in a few hours. I intend a barrage of posts over the weekend. Then, Monday morning, part one of a BIG 2-part surprise, so stay tuned.

We Live in a Zoo

What a day for a title like that, eh? What, with about a million cattle and sheep herding around D.C., trying to get an angle on how they get to be led around by the nose for the next four years...

Alas, politics isn't the core subject of this post. Rather, I would like to introduce you to someone worth paying attention to. I got an email from this gentleman last week introducing himself, and I'm sure glad he did. His name is Erwan Le Corre and he operates MovNat.

The “zoo” is a modern, global and growing phenomenon generated by the powerful combination of social conventions, technological environment and commercial pressures. Increasingly disconnected from the natural world and their true nature, zoo humans are suffering physically, mentally and spiritually.

Are you experiencing chronic pains, are you overweight, do you often feel depressed or do you suffer from frequent illnesses and general lack of vitality? These symptoms indicate that you are experiencing the zoo human syndrome. Modern society conditions us to think that this is normal and unavoidable.

We don’t think so. Our true nature is to be strong, healthy, happy and free.

We have designed a complete education system that empowers zoo humans to experience their true nature.

That stuck an immediate chord with me, as several days earlier I had compared how we had gone soft as humans with the way domestic dogs are ill-equipped for survival on their own, unlike their genetic ancestor, the wolf.

Now, what I'd really like you to take a look at is his video. There is also a YouTube version (of significantly less quality; Later: turns out there's a 'watch in HD' link that is of superb quality) if your particular browser doesn't bring up the one on Erwan's site. The thing to take away from that is to notice how natural and functional are all the movements. This, folks, is the Gold Standard for exercising the body designed by evolution.

Finally, Chris Highcock at Conditioning Research came across Erwin as well, and went and conducted an interview that's very much worth the read. Given the political theme of the day -- the inauguration and replacement of the 'old bad king' with a 'new good king,' and with everyone stumbling over everyone else to see who can more quickly and readily dispense with their individualism in exchange for "hope" and duty to the collective, I particularly liked this bit in Erwan's interview.

The zoo is not just an environment, it is a phenomenon, a process, which is designed to keep you a captive of both external and internal cages. It is something that conditions many of your behaviours: clearly it is to me a domestication system, no less. The zoo impairs our ability to experience our true nature which is to be strong, healthy, happy and free. [...]

But I personally have a problem with morals or ethics when it comes to deciding what is good or what is not good for me, what is done and what's not, what I should do or what society expects me to do or would like to impose to me as some form of duty.

After all, a tool is useful, a cog in the machine is useful right? I accept no institutional duty. Free will is the most precious thing in my eyes. If I choose to be helpful to others, which I in fact often do because I tend to like others, it is because I decide so and not because I have to. The problem is, many people often think of altruism as sacrificing oneself or one's resources unconditionally for others, even for those that are total strangers to you or even if it's going to be seriously detrimental to yourself. I prefer to impose no moral code in MovNat and leave it up to each individual to decide for themselves what is best when it comes to investing their energy or risking their physical integrity for others, because each situation is different. MovNat training will greatly increase your preparedness so that, in time of need, you have the ability to respond efficiently to practical challenges.

Notice this grand distinction, folks: utility is amoral. Pay attention whenever you hear or read of a justification for something on the grounds that it's useful, functional, efficient. Think really hard.

That, my friends, is the essence of individualism, and there could be no greater contrast between that individualism and those old, tired, collectivist ideas straight form the zookeeper's manual -- hauled out and polished up for those ignorant of the failures of history -- delivered by the new Zookeeper-in-Chief, himself.

In fact, I wonder if 'zoo' is even the right metaphor for what we're going to get, now. I think ant farm or bee hive might be a little bit more fitting.

Vegetarian Paleo

Here's how to deal with me when we have a fundamental conflict, unlike some people. A comment from a vegetarian reader.

I see this blog all of the time and I love reading it. I never comment because, as interesting as I think it is... I am newly a vegetarian and am really enjoying this lifestyle choice.

Is it possible to practice this diet with the exclusion of meat?

I keep a foodie blog, tracking my progress as a vegetarian.

Well, I took a quick five or so at your blog and there's no mystery at all. You're having a ball. Quite obvious, and I salute and congratulate you on it. Even though our food choices are not the same, much of what you're doing is real food, you're doing it yourself, and you're doing it with imagination and gusto. Salut!

How could I possibly dis that?

Here's what I think: in spite of you adopting a diet that I would not undertake, I think you're heads & tails above most. I didn't see any fish, and I've had many acquaintances over the years who call themselves "vegetarian" but eat fish and/or shellfish. Could you consider that? It would make me immensely happy if you did.

That approach, if one does it, is an ideal modified-vegetarian approach in my view. The cool thing about fish is that it's as wide in variety as the sea -- really, a whole other world of nutrition. In terms of meat, for most of us, we have beef, pork, lamb, chicken & turkey. Toss is some buffalo, emu, or game meat from time to time. But in terms of fish, you have huge, huge variety in taste, nutritional composition, fat content, texture and other attributes. One can eat very fine and high nutrition with fish, vegetables, fruit and nuts. You will annihilate the grain, legume & sugar eaters in terms of nutrition. Instead of grains, rice, legumes, or sugar, just eat a bigger portion of fish, more veggies, more fruit (berries preferable), and/or nuts. Then laugh at your malnourished interlocutors.

I aim for optimal nutrition from food. So, I'm going to try to eat from as wide of a variety as practical; from meat, fish, natural fats, vegetables, fruits, and nuts / seeds.

So now let me get to some critiques of the vegetarian path.

1) You have to get a decent amount of protein or you'll lose weight, as many vegetarians do. This fools them into thinking they are on a good path, but what their body is doing is scavenging lean mass and bone in order to make up for malnutrition. They become skinny fat, i.e., low body weight but relatively high body fat percentage.

2) Since you're not going to get protein from natures most readily available (and tasty) sources, you're stuck with legumes in general, and soy in particular. I've blogged before about lectins, but soy is probably one of the worst (follow the links). In short, lectins are everywhere, but the ones found in legumes and grains are ones we haven't had exposure to long enough to adapt to. For some people, this means a peanut can kill them, and for others, wheat and other gluten containing "food" can melt their gut. So here's what you have to consider: Peanuts don't kill you, nor does wheat and other gluten heavy grains cause immediately noticeable harm. But what do you know of your generalized inflammation, inflammation that may lurk below the pain threshold? You might want to get a blood test for c-reactive protein.

3) This may not apply to you, evidence thereof being your blog, but more and more, vegetarians are straying from the whole foods path to processed foods. Let's just say that highly processed foods eaten chronically are death to all, from vegan to carnivore.

Now, in the interest of objectivity, allow me to highlight the fact that I don't think vegetarians and vegans are entirely deluded. Here's an example:

"Raw For 30 Days" - Vegan Cure for Diabetes

I think that's cool & awesome. But the same thing could have been accomplished with a Paleo diet, and what's more: it's sustainable.

Alright, I believe I've made my point, which is: I think a careful vegetarian diet that eschews processed foods and sugar entirely is probably better than the average American diet -- even one including meat. And that's because the average American diet includes a ton of wheat & sugar. Most simply: vegetarian diets have sometimes been shown to deliver net benefit simply because vegetarians are of an above-average health consciousness, and that's a bigger association to overall health than the specifics of your diet. Because of their fundamentals, they are going to eat closer to nature, closer to the Paleolithic, and that's going to have a net benefit on some scale.

As a last bit, I've often described the vegan diet as one of "long-extinct pea-brains and chimpanzees." As I've remarked on before, the two lines of hominids that were vegetarian (other than the bugs, worms and caterpillars they all consume) went extinct like a couple of million years ago. Still, if one is vegetarian or has even mildly been exposed to the rational, one has with little doubt been exposed to the "argument" that our digestive tracts are more like those of "vegetarians" than of carnivores.

Do you mean: like these vegetarians. (Note added later: Bea just saw this, said it freaked her out, and that I needed to emphasize that you take the time to watch it. It will blow you away.)

(HT: To the commenter on a previous post who clued me into that, and this.)

Saturated Fat

Who eats the most of it? Think you know? Let's speculate first, based on heart disease death stats, by country.

Picture 13

So, if the "diet-heart hypothesis" were true in its general position on fats, and on saturated fats in particular, then ought we not see some significant correlation between saturated fat intake and coronary heart disease deaths?

That graph above coveres only the first 15, but there are 26 countries if you click the link above. Well, let me let the cat out of the bag and just tell you that the highest saturated fat intake isn't among the first 15. And guess what, it's not even on the list of 26 at all, which goes all the way down to 30 deaths per 100,000 people.

In the United States, average saturated fat intake is estimated at around 12% of total energy. Now, what if I told you there was a country where it's documented that the population derives about 50% of it's energy, not from just fat, but from saturated fat! That is, they get about 60% of total energy from fat, 50% of which is saturated.

And they're not even on the list. Note: I realize the list is likely recent stats and the island in question probably has a much more modern diet now. The list is merely for illustration and a bit of blog drama. So for the real serious data and analysis, Stephan has the goods.

There are two reasons why the Tokelau Island Migrant study is unique. First, it's one of the best-documented transitions from a traditional to a modern lifestyle, studied over decades on Tokelau and in New Zealand. Regular visits by physicians recorded the health of the population as it shifted from a relatively traditional diet to a more Western one. The second thing that makes this population unique is they traditionally have an extraordinarily high saturated fat intake from coconut. They derive between 54 and 62 percent of their calories from coconut, which is 87% saturated. This gives them perhaps the highest documented saturated fat intake in the world. This will be a test of the "diet-heart hypothesis", the idea that dietary fat, cholesterol and especially saturated fat contribute to cardiovascular disease!

And from another post in the series:

The Tokelau Island Migrant study isn't a perfect experiment, but it's about as close as we're going to get. Tokelauans traditionally obtained 40-50% of their calories from saturated fat, in the form of coconut meat. That's more than any other group I'm aware of, even topping the roughly 33% that the Masai get from their extremely fatty Zebu milk.

So are the Tokelauans dropping like flies of cardiovascular disease? I think most of the readers of this blog already know the answer to that question. I don't have access to the best data of all: actual heart attack incidence data. But we do have some telltale markers. In 1971-1982, researchers collected data from Tokelau and Tokelauan migrants to New Zealand on cholesterol levels, blood pressure and electrocardiogram (ECG) readings.

You can learn the results on Stephan's blog, but the punch-line is that the Tokelauans had ECG readings with 0.0% of men showing markers for a past heart attack, while substantial numbers of men in New Zealand -- where saturated fat intake is 50% less -- showed up with the markers.

Here's the thing, folks: falsification. For any hypothesis, you need but one observation that contradicts it, and you're done. For hypotheses like "saturated fat causes heart disease," every single hunter-gatherer and other non-industrial population that has been studied directly contradicts it. Game over.

So, Stephan does his typical marvelous job in sorting through all the relevant material, so why not go over and have a look.

Stephan told me in an email a couple of days ago that he's not done, yet. So, you might want to follow along by checking his blog regularly.

Reader Questions

Reader Auti emails in:

You look 30 years younger and absolutely amazing! I am impressed with your results...

I am a 31 year old nurse. I follow Marksdaily apple as well as Arthur De Vany. I have dabbled in low carb only to go on a splurge by the end of the night when my cranky mind is driving me toward that oh so yummy and deadly cookie.

Not that I am over weight, because I am not but I followed a low fat calorie counting diet for a long time and it made me very food obsessed. I want to find the joy again and I definately found that once I stopped dieting.

However, now I want that energy, clear thinking, drive, reduced risk of cancer, no risk of diabetes, and youthful aging. I am sure it is a low carb diet but I have yet to perfect it.

Can you offer any advice as to what you have learned and how you have stopped cheating...

OH my goodness, you eat so much fat. I am not a fat free person (I used to be) but I would be scared my ass would grow bigger if I did that. Do you think that this diet is ok for women as well as men or are we different in some way?

First of all, notice how you recognize the food obsession. This is key. Hunger (see here too). The truth is, the Paleo way is the only way I know to cure the obsession and get control of hunger. I think this is why many low-carbers fail. Low carb is a fine approach, but not fundamental. A true Paleo diet can vary widely in terms of carbohydrate, because that's not fundamental or essential. Eating foods we evolved to eat is essential, and for most people (obese and/or diabetic would be an exception), that in itself will be enough to utterly transform them.

And it's not just on the outside, but also on the inside where these obsessions live. I have found personally that I not only look younger, but I feel far younger and my attitude is far closer to the way it was when I was back in college. To some extent, I have become somewhat carefree in the sense that I no longer obsess about much of anything. I think modernity has set us up in such a way that we grossly overestimate the quality of our own knowledge; and worse, we put far too much effort into trying to predict and control future outcomes. You simply have to adopt and take care of sound principles, and then see what the future brings.

So, though I still do cheat, it is truly becoming less frequent because I'm not hungry and I'm not obsessed. When I do eat, I replace the normal low-nutrition foods like bread, pasta, rice, legumes, and sweets with more meat, more fat, more veggies, or some fruits or nuts, or a combination of all. So, just my very exercise of eating, in itself, gives me 100 - 300% more nutrition for the same calories as what most other people eat. Could it be that's why Paleo eaters experience a wild taming of hunger and other obsessive behaviors? That would be my speculation. Having a fully nourished body would naturally balance hormones. I'd have to say that my guess would be that food obsession is rooted in hunger, and hunger in malnourishment. Even if one is getting sufficient energy on an average diet, they are most likely malnourished in a number of important nutrients. When that happens, I would speculate that it sets off cascades of hormones that result in a person becoming ravenous and obsessive about food.

I think this diet is perfect for both men and women. It's nature's diet. How else can it be? And besides, you're only 31. There are disputes about fat content and saturated fat. I uniformly think they are all wet and I think Loren Cordain is dead wrong, both about protein and fat proportions, and about saturated fat. Fat is king. If someone thinks they are going to get 35% of energy from protein so they can watch the fat, I think they are fooling themselves. Fat is king. Fat is what makes this work. We simply must get over the notion that natural fats are anything but very healthful and nutritious.

Americans are so fat for one primary reason: fear of fat. That is the dammed truth.

Later: A friend just emailed this article about the differences in hunger between men and women. What I take from that is it's even more crucial for a woman to be on a Paleo-like diet.

Surf & Turf

Bea & I decided to split a ribeye steak and a dungeness crab last night.

Surf & turf

Notice the clarified butter. I like to make my own rather than use ghee, because I like it just slightly browned. That makes for a slightly sweet taste that goes way good with the crab (steak too, actually). The steak has what I call a "drizzle." I pan fried it in bacon dripping in a casr iron skillet, medium high, and with a lid that would just cover the steak. It was about 2 1/2 minutes on one side and 1 1/2 on the other, covered. Then, let the steak rest, dump off all but about a tablespoon of the fat, and then deglaze the pan with some red wine, about 1/4 cup. Scrape with a spatula as the wine evaporates; about two minutes. Then when it's thick like a syrup, check the steak. You'll notice it has released some of its juices, and you stir those back into your glaze, then drizzle on the steak. Way yummy, and easy.

Paleo Tales of Success

I find that many people don't really grasp the essence of the Paleo (and Paleo-like) way. They approach it like they approach other diets, focus on what you can't have, and eventually go on in their endless quest for some silver bullet.

To my mind, the Paleo way is about two things, primarily.

1) To obtain not just sufficient or even good nutrition from food, but to obtain optimal nutrition from food. So, with respect to that piece of bread, pile of rice, dessert -- or any of the other things we don't eat -- we're eating, in its place, an additional piece of meat, fish, more vegies, fruit, or what have you. Over a week, or even a day, were you to compare your nutrient intake to any other average diet, you would blow it out of the water. Big time. It's not even close.

2) Hunger normalization. The problem with this one is that most people have no idea that their hunger it totally berserk. They consider the idea of fasting, for instance, and it's horrifying. Yet, people on the Paleo way embrace fasting naturally. Why? Because hunger is a hugely different experience for someone on the Paleo path.

Here's three testimonials that touch on one or both of these crucial elements.

Diana Hsieh emailed me back in Septamber to thank me for the blog. She'd been following it for some months, used the information, and benefited. And now look.

Diana-compare-sm

So after years of following various iterations of the low-fat, chubby face diet, look. She's taken a good 20 years off her appearance. You can read her whole story here.

I'm really thrilled with my weight loss. I've been battling my slowly-growing layer of fat since 2004. For four long years, I exercised daily: I did the standard regimen of 40 to 60 minutes of cardio. I attempted to eat "healthier," mostly meaning less fat, less calories. I was often ravenously hungry; I often felt deprived; I desperately craved sugar. Worst of all, despite some occasional success, my weight continued to creep upwards. I felt like I had no control.

And I'll bet Diana's former diet was about as healthy in terms of nutrition you can get on a low-fat regime. Her husband, Paul, is a physician and Diana is months away from obtaining her PhD in Philosophy. They live on a farm. I doubt she was eating junk food all day. Notice how she used to look pretty much like an average American, nowadays. Now, as with all Paleo people who've been on the diet a while, she looks lean and healthy. Far above average.

Now, of course, I love when someone documents success like that and it turns out I had a role in it. At first, it seemed unbelievable that people would actually take me seriously enough to try some of these methods, but you know what? I guess that sometimes people can recognize genuine when they see it. Dr. Dan of At Darwin's Table has only been blogging a short while, and like me, much of it is about his own path in losing weight and gaining health through optimal nutrition from food. Yet he already has an amazing reader success story and I'd highly encourage everyone to read that.

Confessions of a Carb Addict

I really, really used to think I had an eating disorder. Here I was at 30 years old - 108 kilo on a 5′2″ inch frame (that’s 238 pounds and 158 centimetres respectively) and massively unhappy with my body, my appearance and dieting like a fiend. I didn’t try the proverbial “everything” to lose weight, but I tried a great number of things, the Gillian McKeith “You Are What You Eat” diet, Weight Watchers, Intuitive Eating, food combining, vegetarianism, I even took part in a special addiction workshop because I was convinced I was addicted to food. [...]

...I was never, ever full. Never. EVER. [...]

...That of course meant I had blown the diet and so all food became fair game, but then no matter how much I ate I WAS NEVER FULL! NEVER. EVER. FULL! [...]

I don’t remember how I found Dr Dan’s blog, but because of him I read Loren Cordain’s book, tried it out for about one month, cutting out dairy and grain and have never looked back since. I’ve lost about 4 kilo after about 6 weeks of practice and - although I can’t claim the Paleo way has saved my life, it has most definitely saved my sanity. All those feelings of fear, desperation, anger, and madness have disappeared. I’m calm for the first time in my adult life. I’m eating well and slowly but surely letting my disordered patterns go. I’m not totally free yet, I’m scared about the amount of food I can put away, I mean, dude. I can EAT. But I keep reminding myself that my body is playing catch-up and I am healing my body, NOT hurting it. My knees and hips have stopped hurting and you know what? I’m hungry right now but…it’s cool. This is the first time in my whole life that I have not felt like climbing the walls when I’ve been hungry. This is a different kind of hunger, it’s not sickening or acidic - this is a different way of living my life because after an eternity, I AM CALM.

Get it? She's getting optimal nutrition, losing weight, getting control of hunger, getting healthier. That's just a bit of her story excerpted. Go read the whole amazing thing.

And now, Keith Norris, already a well-established Paleo eater and experienced exerciser finds that last bit of success in intermittent fasting (with photos). I have blogged extensively about fasting myself, and can attest that Keith has it right on, and also with some of his own unique takes on the methodology. There's too much to do a good job of excerpting, so just go take a look at his photos and read his story.

Veggie Color & Spaghetti

Let's get right to it. The other night I had family over and did a Thai green curry. While I didn't get a final dish pic, here's a transitional, all color.

Color vegetables

Prior to this, I did the chicken breast and Polish sausage (in coconut oil). In a separate sauce pan, I heated a can of coconut oil and about a couple of tablespoons of Thai green curry (should be able to get in most supermarkets). Once the veggies were well on their way, I added back the meat, dumped the curry over the whole thing, covered and simmered about 15 minutes. It was devoured.

Inspired by Mark Sisson, I tried my hand at spaghetti squash last evening. Rather than his meat sauce recipe, I used my mom's (with a few of my own mods). Here's the ingredient list in photo.

Spaghetti sqash ingredients

So we have ground beef (I used lean, this time, as free tallow doesn't improve the taste of this sauce), onions, green bell pepper, celery, mushrooms, canned tomatoes, olives, and tomato sauce. Spice & herb wise, we've got the fresh parsley, oregano, and basil, and in addition, dry Italian seasoning and marjoram will go in. I also used about a half bulb of crushed fresh garlic.

In terms of quantity, it's hard to ruin this. For the dry spices, about a tablespoon each. All the canned stuff went in completely (drain the olives). For the fresh herbs, about a half handful chopped into the cooking. For the spaghetti squash, puncture the skin a few time, and into the oven at 350 for an hour, cut in half, scrape out the seeds. Once I got the sauce going, I did a low simmer for about 3 hours.

Here's how the spaghetti squash works.

Spaghetti sqash

And now for the final, garnished with some additional fresh parsley, parmesan, and basil.

Spaghetti squash

I believe I recall having this squash as a kid, not sure, but I must say that of all the "low-carb substitute" dishes that attempt to mimic a favorite, this one is by far the best. While there's a tradeoff as good al dente pasta can be quite pleasing to the pallet, this has a very pleasant crunch, a striking freshness, and a bit of sweetness.

A very worthwhile endeavor.

Vitamin D and All-Cause Mortality

This is from August, but I just stumbled on it. Here's a study published in Archives of Internal Medicine.

25-Hydroxyvitamin D Levels and the Risk of Mortality in the General Population

Conclusion: The lowest quartile of 25(OH)D level (<17.8 ng/mL) is independently associated with all-cause mortality in the general population.

I like this kind of science because, duh, why trade risk of one disease for another? That's the big blind spot with so much of the research surrounding obesity, heart disease, cancer, diabetes, etc. They associate one disease with one thing (like high cholesterol with heart disease -- but not really), only to find out that "the fix" increases risk for another disease, or worse, as in the case of low cholesterol, increases risk of...death. That's right, particularly for an elderly person. If you're patting yourself on the back over low cholesterol, studies repeatedly show that low cholesterol is associated with higher rates of dying. In other words, on average, people with high cholesterol simply live longer. So, go ahead and undertake questionable dietary habits and take questionable drugs in the pursuit of a questionable association, only to die earlier -- only not of a heart attack. Yay; you win!

Skeptical? After all, you probably didn't hear about this one on the evening news, didj'a (it would have been in conflict with the Lipitor commercials)? So here:

Cholesterol and all-cause mortality in elderly people. "Only the group with low cholesterol concentration at both examinations had a significant association with mortality."

Low Cholesterol Levels Associated with Increased Mortality

Yet Another Study Shows Low Cholesterol Increases Risk Of Early Death!

That was just a sloppy and quick Googling. I could give you dozens more.

So, anyway, now that we understand the importance of looking at all-cause mortality over cherry picking various diseases independently of risk factors for others, let's tun back to vitamin D and mortality. ScienceDaily did a good writeup on it. They quote co-lead investigator Erin Michos, M.D., M.H.S.

Our results make it much more clear that all men and women concerned about their overall health should more closely monitor their blood levels of vitamin D, and make sure they have enough...

We think we have additional evidence to consider adding vitamin D deficiency as a distinct and separate risk factor for death from cardiovascular disease, putting it alongside much better known and understood risk factors, such as age, gender, family history, smoking, high blood cholesterol levels, high blood pressure, lack of exercise, obesity and diabetes...